condoms

Condom-free, non-hormonal male birth control?

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by Mary Koenig

What is it?

Vasalgel is a non-hormonal, long-acting, and reversible form of male birth control. Developed by the Parsemus Foundation — a nonprofit organization that works to develop low-cost medical approaches, Vasalgel is a one-time polymer injection based on a different technology called RISUG (reversible inhibition of sperm under guidance) developed in India over 15 years ago. Based on initial animal trials, Parsemus expects that Vasalgel will be as effective in preventing pregnancy as vasectomy.

How does it work?

Vasalgel works by physically blocking the vas deferens, the tube through which sperm pass on their way out of the body. The polymer can be flushed out with a second injection for anyone who wants to start having children.

Who can it benefit?

Obviously, Vasalgel could benefit men who have sex with women; who want to be in control of the birth control methods they use; desire a long-lasting, reversible, one-time method; or who worry about the effectiveness of other forms of birth control.

Vasalgel could also benefit women who have male sexual partners who cannot or would rather not use any of the forms of female contraception available due to their side effects and health impacts.

It could drastically reduce the number of unintended and unwanted pregnancies.

Lovers
Photo by Ben Cutshall, “Lovers.” Flickr, Creative Commons.

Vasalgel could also benefit society as a whole. Including men in the conversation about who controls or is responsible for birth control — a responsibility that has historically, for the most part, fallen on women’s shoulders only — could change the ways we think about . This could create more equitable relationships between men and women, and in society as a whole.

What are the risks?

Because of the way it works, Vasalgel does not protect against the transmission of STIs (sexually transmitted infections) like barrier methods do. Some doctors have expressed concern that men using Vasalgel may be less likely to also use a barrier method — like a condom or female condom — with new or untested partners, increasing their risk for STI.

When can we expect Vasalgel to be available?

The Parsemus Foundation aims to start human trials for Vasalgel next year and estimates that Vasalgel may be on the market as early as 2017.

 

Mary is a recent graduate of UNC-Chapel Hill and a program assistant with UNC Student Wellness. She is interested in health equity, social justice advocacy, and violence prevention initiatives. When she’s not working, she likes to play and listen to music, cook, and snuggle with her cats, Buffy and Giles.

Condom Media: Effectiveness vs. Popularity?

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Previously in the HealthyHeels blog, we’ve written about the misperception that some condom brands perform significantly better than others. It turns out that, in order to be available to US consumers, all FDA-approved condoms must pass rigorous minimum safety and quality trials (having at least 996 of a 1000 condoms pass a “leak” test to ensure they will not break during sex). There have also been studies examining condom break rates between brands which have found that breaking was extremely uncommon, and that breaking was not related to brand type.

Still, the perception that some condom brands are more effective than others is common. In a recent public condom campaign in Washington DC, there was widespread concern among highschool- and college-aged students about the quality of the free condoms available. So much so that local health officials re-thought their choice of condom – despite the comparable efficacy of condom brands.

So if the FDA-approved condoms are all held up to rigorous testing and standards, and all perform similarly to each other in terms of break rates, then what accounts for the common perception that some are more effective than others?

Along with about a dozen million others, I was seriously into the show Mad Men. I think one of the more interesting aspects of the show is how branding, recognition and advertisement all affect how we perceive products. Our perceptions of quality, popularity and trustworthiness of many products are very much tied to product presentation: what the packaging looks like and what the ads communicate. There are tons of commercials and ads out there for safer sex products, the most prominently featured of which are probably personal lubricants and male condoms. When students I meet with felt iffy about condom brands provided by Student Wellness, they also seemed to prefer brands with larger media recognition. This had me wondering: “does the marketing and labeling of condoms affect our perception of the products themselves?”

Duane Reade protection
Photo: “Duane Reade Protection” by J Pride. Flickr Creative Commons.

There is no real answer to this, but while doing research on the media campaigns of various condom brands, I did come across some pretty interesting stuff.

One interesting thing is the amount of money dedicated to condom media and advertising by each of the condom brands. According to a Kaiser Family Foundation report, “Carter-Wallace spent a high of just $2.2 million in a year on advertising for Trojan condoms on cable TV, and less than $500,000 on broadcast; in 2000, its cable buy fell to $1.7 million. Its competitor Ansell registered less than $40,000 in annual TV spending for LifeStyles condoms during the 1997-2000 period.”

Another interesting thing is the regulations on condom ads through the years. Fun fact: condom commercials only started airing on national networks in 1991. There are also lots of regulations on condom ads. According to the Kaiser report: “Some of the networks and stations that accept condom commercials impose certain limits on them, such as restricting the time of day they can be run, or requiring their messages to be focused on disease prevention [such as sexually transmitted infections] rather than birth control.” The Kaiser report also spells out the restrictions on condom ads by national network.

Again, there’s no definitive answer to why some brands are perceived as better than others, and it is largely influenced by a number of factors. Still, the role of the media in promoting (or not promoting) condoms is very interesting. So, I open up the question to you our readers: what do you think? Do you think condom branding has affected our ideas surrounding condom use?

FLASHBACK FRIDAY: Condom effectiveness: What’s brand name got to do with it?

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This blog was originally posted on April 25, 2012 and was written by Diana Sanchez.

Condoms are one of the most commonly used contraceptive/STD prevention products used worldwide. The United Nations Population Fund estimated that over 10 billion condoms were used in 2005.  Here on campus, Campus Health Services provides thousands of condoms to students each year.

As a sexual health counselor, I have noticed that many people’s preferences for certain condom brands are based (almost entirely) on their perception of that condom brand’s effectiveness. We offer a variety of condom brands for free to students through Campus Health Services. Occasionally, when people check out the condoms we have available, they’ll ask: “are those safe to use?”, and “don’t those break more than [other condom brand]?”.

So, do some condoms in fact perform better than others in terms of STD/pregnancy prevention?

The answer is no, not really. Condoms are regarded by the United States Food and Drug Administration (FDA) as “Class II medical devices”, a designation that includes pregnancy tests and powered wheelchairs.  Products in this category have to meet special labeling requirements and performance standards. For condoms, the FDA standards include systematic “water leak” tests to ensure that no fluid can leak out of the condoms. To meet standards, all condoms must have at least 996 out of 1,000 condoms, on average, pass this test. This means that FDA-approved condoms must be at least 99.6% effective in laboratory tests to be available to consumers.

In a 2004 publication, Walsh and colleagues used condom use data from trials of three bands of condoms, including Trojan, LifeStyles and Ramses – all of which are FDA-approved condom brands. Out of 3,677 condom-protected sex acts analyzed in the study, the authors found that 55 condom acts failed, either due to breaking (16 condoms broke; break rate = 0.04%) or slipping (39 condoms slipped; slip rate = 1%). The likelihood of condoms breaking during sex was not statistically associated with condom brand.

FDA-approved condoms are all quite effective at preventing pregnancy and STD, and performance is probably not related to brand type. You might be wondering if the condoms you’re using are FDA-approved. With the exception of novelty condoms (which are pretty uncommon), just about all of the condoms you’ll come across in the United States are approved by the FDA.  All the condoms we provide through Campus Health Services are FDA-approved, and same goes for places like Planned Parenthood and local STD/HIV clinics. If you’d like to be certain, you can check the condom packet to look for wording about STD and pregnancy prevention. If it’s on the packet, those condoms meet federal regulations for quality and safety.

Check out the following pictures to see how we’ve looked for this language on some condoms we provide at Campus Health Services:

If you can’t find language about STD/HIV prevention on condom packaging, then it’s not FDA approved.
If you can’t find language about STD/HIV prevention on condom packaging, then it’s not FDA approved for STD/HIV and pregnancy prevention.

All of this said, although condoms must be at least 99.6% effective in safety trials, testing conditions do not necessarily mean 99.6% real-life effectiveness for any condom brand. But here’s the good news:  there’s a lot you can do to increase the effectiveness of condoms. One of the biggest challenges to condom effectiveness is correct use.  Some of the most common errors with condom use are: using the wrong lubricant (water-based, NOT oil-based, lubricants should be used with condoms); incorrect storage (ie, storing a condom in a hot place, like a glove compartment, or in a place with lots of friction, like a wallet or pocket); and not checking the expiration date.

FLASHBACK FRIDAY: Barriers to using barrier methods?

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This blog is a guest blog from Ruth Abebe, a UNC graduate interested in HIV and sexual health, and was originally published on April 1, 2013.

College is a time when many students are discovering and exploring ourselves and the condomsworld around us. This world may include sexuality.

Many college students choose to be sexually active, and college-aged students are particularly likely to engage in risky sexual behaviors and are disproportionately affected by negative sexual health outcomes such as STI or unintended pregnancy.  According to national surveys, many college students are engaging in sexual activity without protection. In a 2011 survey of undergraduate students across the US, approximately 70% of sexually active students reported using condoms inconsistently or not at all during sex in the last 30 days. With all the information out there regarding sexually transmitted infections (STI), unintended pregnancy and ways to prevent them, why do college students still put themselves at risk?

As a college student myself, I have heard several of my peers talk about why they don’t use condoms.  But, there are ways to go beyond these barriers and make sure sexual experiences are safe and pleasurable.

1. Cost — Most of us are on a budget, and the cost of safer sex supplies like condoms is still an obstacle for students when deciding to use protection. However, this is a problem that can be easily remedied. Here at UNC, we have access to free safer sex supplies. Condoms, both male and female, and dental dams, as well as lube, are available to us through UNC Student Wellness and at several residence halls around campus. Furthermore, with the introduction of Wellness’s free condom dispensers, cost will be even less of an issue (update: These condom dispensers are now in service! They are located around campus, including in the Union and the Rams Head Recreation Center, and are refilled frequently). Click here for more information on where you can currently access safer sex supplies throughout Campus Health Services.

2. Many consider only pregnancy risk—Some students only consider pregnancy as a possible consequence of unprotected sex. For this reason, many believe they will be able to protect themselves using prescription contraceptives (examples: the pill, patch, ring, IUD, etc.). However, STI risk and protection should be considered in every sexual partnership.  Aside from abstinence, condoms are the only method which can protect against both pregnancy and STIs, including HIV/AIDS. They can also be converted to a dental dam.

3. “Oral sex isn’t sex.” – Many are under the false impression that oral sex is “safe sex.” Oral sex, just like anal and vaginal sex, carries a risk for STI transmission.  Condoms and dental dams can protect against the risk of STI transmission during oral sex.

4. Pleasure Factor— Some college students don’t use condoms during sexual activity because they believe “it doesn’t feel the same.”  But you can do things to make sex with condoms feel just as good. Plus, knowing that you have the protection of a condom can help you to relax and enjoy the moment.  There are several kinds of condoms out there, including “ultra-sensitive” condoms that enhance the feeling of both parties during sex. Using lube can also make sex more pleasurable for both partners. In addition, there are condoms and other safer sex supplies geared toward making sex more pleasurable. Explore different condom styles and protect yourself!

5. “It’ll ruin the moment.” – Some college students are not protecting themselves for fear of ruining the mood of the moment. There are ways around this too. If you are having sex with someone, you can talk about condom use beforehand. Of course, I realize that not all sexual activity will be between two people in either a romantic or ongoing sexual relationship. In these cases, it’s important to place your sexual health above any potential awkwardness. Cases of STIs are on the rise, and aside from the dangers to your health, having an STI can make your sex life more difficult in the future. So, why not protect and enjoy yourself?

Despite these barriers, there are several ways to allay your fears and hesitations about using protection. As college students, preventing against STIs and pregnancy by using condoms is essential to protecting our sexual health.

Whose responsibility is it to carry condoms?

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The condom is like the Swiss army knife of protected sex:  in one unit, you’ve got protection that can be used for a variety of situations, for a variety of sex acts, for a variety of partnerships.

Condoms are the only contraceptive method that helps prevent both pregnancy and sexually transmitted infections (STI). Male condoms can be used on men during oral, vaginal and anal sex; female condoms can be used in women during vaginal sex and anal sex. With a quick snip, both male and female condoms can also be converted to dental barriers for use during oral-anal and oral-vaginal sex.

But in the heat of the moment, who provides the condoms?

There are plenty of people who would argue that it’s a particular person’s “job” to have condoms available: “the guy’s responsibility”; “the girl’s responsibility”; “’responsibility of whoever initiates sex”, etc.

There are no rules out there about who needs to buy or bring safer sex supplies. In theory, if it’s a shared goal to prevent pregnancy and/or STI, then it’s a shared responsibility to do things to prevent those outcomes.

Of course, in practice we at Campus Health Services (CHS) recognize that there are lots of reasons why people don’t have condoms available. Condoms can be expensive. Acquiring condoms before sex requires some planning and foresight. Additionally, for many, condoms can be kind of embarrassing to get or buy. Having them available makes some people nervous that their partner will think they’re promiscuous.

Luckily, CHS makes it easy to get condoms for those who want them! First, they’re FREE to students, so no need to worry about cost. Second, they’re available at various locations in fishbowls and examination rooms throughout CHS, and provided free of charge to most students through their resident advisors or housing communities.

Here at CHS, we strongly believe that sex is a healthy part of relationships and there shouldn’t be shame or judgment associated with having sex or acquiring condoms on campus. We also believe that having condoms does not make you or your partner promiscuous; it makes you prepared. If you’re shy about getting condoms at fishbowls in campus health locations, reach out to a Sexual Wellness Specialists (formerly CHECS)(sexperts@unc.edu) and we’ll hook you up with condoms privately.

And for tips on how to discuss sex (and condom use) with your partner, see our previous blog post on conversation with sex partners.